Provider Demographics
NPI:1962573618
Name:GARRISON, CATHERINE MAGUIRE (CRNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MAGUIRE
Last Name:GARRISON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 DEKALB PIKE
Mailing Address - Street 2:STE 104
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1223
Mailing Address - Country:US
Mailing Address - Phone:215-997-9441
Mailing Address - Fax:215-997-6730
Practice Address - Street 1:676 DEKALB PIKE
Practice Address - Street 2:STE 104
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1223
Practice Address - Country:US
Practice Address - Phone:215-997-9441
Practice Address - Fax:215-997-6730
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008601363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ63822Medicare UPIN
PA098515Medicare PIN